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Clinical, Epidemiologic and Microbiologic Features of a Persistent Outbreak of Amikacin-Resistant Serratia marcescens

Published online by Cambridge University Press:  02 January 2015

Julio C. Arroyo ,
W. Lloyd Milligan ,
Bosko Postic ,
Jimmie Northey ,
Ellen Parker  and
Charles S. Bryan
Julio C. Arroyo*
Affiliation:
Medical, Laboratory and Nursing Services, Wm. Jennings Bryan Dorn Veterans' Hospital, and the Department of Medicine, the University of South Carolina Medical School, Columbia, South Carolina
W. Lloyd Milligan
Affiliation:
Medical, Laboratory and Nursing Services, Wm. Jennings Bryan Dorn Veterans' Hospital, and the Department of Medicine, the University of South Carolina Medical School, Columbia, South Carolina
Bosko Postic
Affiliation:
Medical, Laboratory and Nursing Services, Wm. Jennings Bryan Dorn Veterans' Hospital, and the Department of Medicine, the University of South Carolina Medical School, Columbia, South Carolina
Jimmie Northey
Affiliation:
Medical, Laboratory and Nursing Services, Wm. Jennings Bryan Dorn Veterans' Hospital, and the Department of Medicine, the University of South Carolina Medical School, Columbia, South Carolina
Ellen Parker
Affiliation:
Medical, Laboratory and Nursing Services, Wm. Jennings Bryan Dorn Veterans' Hospital, and the Department of Medicine, the University of South Carolina Medical School, Columbia, South Carolina
Charles S. Bryan
Affiliation:
Medical, Laboratory and Nursing Services, Wm. Jennings Bryan Dorn Veterans' Hospital, and the Department of Medicine, the University of South Carolina Medical School, Columbia, South Carolina
*
Infectious Diseases Section, Medical Service, Wm. Jennings Bryan Dorn Veterans' Hospital, Columbia, S.C. 29201
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Abstract

This article describes a prolonged outbreak (January 1977 to February 1980) of amikacin-resistant Serratia marcescens (ARSM) urinary infections and the methods used for its control. Significant factors predisposing to ARSM urinary tract infection included an extended hospital stay, being in the urology ward, and undergoing urologie surgery. There had been no prior administration of amikacin or of other aminoglycosides in 20 of 27 patients with ARSM urinary tract infections. Chronically infected patients who required multiple hospitalizations represented a major reservoir for the perpetuation of the outbreak, overshadowing the importance of aminoglycoside use. Traditional control measures and even a major change in the inanimate environment were only partially effective in controlling the outbreak, but treatment of bacteriuric patients in the urology unit with “second and third generation” cephalosporins interrupted patient-to-patient transmission. No new cases of ARSM bacteriuria appeared in the urology unit in the ensuing 12 months [Infect Control 1981; 2(5):367-372.]

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 2 , Issue 5 , October 1981 , pp. 367 - 372
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1981

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